OCTOBER - 20228David Lubarsky, CEO, UC Davis Medical CenterByTHE WINDS OF CHANGE IN HEALTH CARE TODAYThere is an old Chinese proverb that says, "When the winds of change blow, some people build walls, others build windmills." It's a good reminder that every crisis presents not only challenges, but opportunities.Change is always difficult, and nothing is quite as motivating for change as a crisis.Since the pandemic started, dramatic choices and numerous opportunities have arisen in health care. The pandemic didn't introduce digital health, but it certainly accelerated its adoption. Three of these changes are dramatically reshaping the health care landscape right now.1. Creating `Hospitals of the Future'One of the lessons of the pandemic is hospitals have to be more flexible in their ability to adapt to patient care needs. The hospital of the future will have to deliver superior patient outcomes with increasingly sick patients and with greater provider efficiency while becoming more sustainable and keeping a focus on improving health, racial and gender equity. At UC Davis Health, we're building one of largest of these hospitals ­at 1 million square feet and a $3.75 billion budget­with an opening date in 2030. What will make it different, because of the pandemic, is that more 2/3 of the rooms will be acuity adaptable and can be converted into ICU rooms, if needed.Future hospitals will have to be smarter, with AI-enabled technology helping providers even more ­ not artificial intelligence but "augmented" intelligence. It will be critical to deliver a better patient experience ­ closer to a hotel than the current noisy health care setting, which is not only more enjoyable, but stress reducing which improves healing. It's also going to have to be prepared to care primarily for higher acuity patients, as low acuity inpatient care will virtually disappear over the next decade. Those people who do require hospitalization will likely require longer stays for more complex surgeries or more aggressive treatments that can't be delivered as an outpatient.To balance the patient load regionally, academic medical centers like ours will have to work closely with community hospital partners, to increase the level and amount of care they provide locally, while we concentrate on patients that require more advanced services. These kinds of partnerships are a different kind of triple win in health care, as they are better for patients (care closer to home), community hospitals (increased census) and regional academic medical centers (increased overall patient acuity using that facility to its highest purpose and revenue generation).Another vision is designing hospitals and health systems to better address the social determinants of health. These inequalities have far too long put too many people at a higher risk of poor health and provide fewer opportunities for improving their quality of life. Our hospital is an Anchor Institution in the community, and now we're amplifying greatly what we did before. We're working to lift up people in our surrounding neighbourhoods, with job training, hiring locally, and pursuing local product sourcing, and volunteering locally to enhance the education of kids and to be part of charity driven community solutions like Habitat for Humanity. We are doubling down on our core mission of health, and eliminating health disparities, and making sure our surrounding communities are treated with CLAS (culturally and linguistically appropriate services), have expanded access to needed health care and social services, and that we are capturing necessary demographics in our EMR so we can track and further address any implicit biases or unfair effects felt in underserved communities.2. Reducing Provider Burnout with AI and Digital HealthEveryone seems to agree that digital and virtual health, remote-patient monitoring, home diagnostics, and other advances in connected health care will rapidly grow more sophisticated and expansive in the post-pandemic world. Deloitte's global healthcare 2022 outlook says, "A collision of forces ­ a global pandemic of historic proportions; exponential advances in In My OpinionDavid Lubarsky
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